Assessment of Ultrasonography Diagnostic Capacity in Women with Stress Urinary Incontinence with or without Pelvic Prolapse

Abstract

Aim: The aim of this study was to assess the diagnostic validity of Ultrasonography in women with Stress Urinary Incontinence (SUI) with or without pelvic prolapse.Method: In this cross-sectional study, women with SUI were enrolled. The first group consisted of 25 patients with vaginal anterior wall prolapse, and the other group included 18 patients without vaginal anterior wall prolapse. After Systemic and genital examinations, the patients underwent the coughing test and Valsalva maneuver. The urinary leakage was examined during coughing. All the patients with positive coughing test underwent transprineal ultrasound. The posterior uretherovesical angle (β angel) as well as the bladder neck funneling were evaluated and recorded at both resting and during Valsalva.Results: In the patients with prolapse, the mean values of β angel were 121.0±25.9 and 137.7±24.5 degrees at the rest and during the Valsalva respectively. In the patients without prolapse, the means of β angel were 124.2 and 142.5 degrees at the rest and during the Valsalva respectively. The sensitivity and specificity of β angel were higher in patients with prolapse. During the Valsalva, β angel >120° and Bladder neck funneling showed higher PPV and NPV in the patients with prolapse than patients without prolapse. At the rest; however, β angel >120° delivered higher PPV and NPV in the patients without prolapse group. At the rest, β angel > 114° rendered the sensitivity and specificity of 80% and 55% respectively. During the Valsalva, β angel >129° revealed the sensitivity and specificity of 80% and 45% respectively.Conclusion: It seems that ultrasound is not appropriate enough to be an alternative diagnostic tool for urodynamic test in detecting SUI.